NUR 635 ADVANCED PHARMACOLOGY
MIDTERM EXAM PREPARATION PACK 2026 KEY
CONCEPTS AND REVISION NOTES
◉ Which route of administration bypasses first-pass metabolism in
the liver
Answer: intravenous
◉ Which method of administration has variable and erratic
absorption
Answer: rectal
◉ What is a half-life?
Answer: the time required for serum plasma concentrations to
decrease by one-half, 50%
◉ When is a steady state reached?
Answer: after 4-5 half lives
◉ What is zero-order (nonlinear) pharmacokinetics
Answer: a drug is metabolized at a constant rate per unit time
,◉ Why is help life important
Answer: -determines how frequently a drug must be administered.
-predicts how long toxic effects can last (when the drug is over the
minimum toxic level)
◉ what is Michaelis-menten pharmacokinetics
Answer: the rate of drug elimination is directly proportional to the
concentration of free drug
◉ Why is peak and trough measured
Answer: to see if a drug is within its therapeutic range
◉ What is narrow therapeutic index
Answer: when the difference between effective dose and a toxic
blood level is small
◉ what is a wide therapeutic index?
Answer: Greater distance between effective dose and toxic dose,
requires less intense monitoring
◉ what is drug potency
Answer: the concentration needed to produce measurable effect
,◉ what is the onset of action
Answer: the point in time when the drug's blood concentration level
elicits a response, the first indication that the drug is having a
therapeutic effect
◉ What is bioequivalence?
Answer: Two drugs that demonstrate comparable bioavailability and
similar times to achieve peak blood concentrations
◉ what is therapeutic equivalent
Answer: Drug products are considered to be therapeutic equivalents
only if they are pharmaceutical equivalents and if they can be
expected to have the same clinical effect and safety profile when
administered to patients.
example: ACE inhibitors (lisinopril, ramipril)
◉ what is therapeutic index
Answer: Ratio of a drug's toxic level to the level that provides
therapeutic benefits
Calculation LD 50 / ED 50
◉ What is margin of safety
, Answer: The margin between the therapeutic and lethal doses of a
drug
◉ Why are loading doses given?
Answer: reach a therapeutic effect quicker
◉ Examples of medications with loading doses
Answer: aminoglycosides (gentamicin) or azithromycin, digoxin
◉ Do loading doses altered for patient metabolism or elimination
Answer: No. Loading doses are the same for every patient
◉ What initiates biochemical reactions
Answer: Drugs bind to cellular receptors. Pharmacological effect is
due to the alteration of an intrinsic physiological process and not the
creation of a new process.
◉ Example of the actions that can occur when a drug binds to a
receptor
Answer: -ion channel is opened or closed
-second messenger is activated (cAMP, cGMP, inositol phosphate,
initiates a series of reactions
-normal cellular function is inhibited
MIDTERM EXAM PREPARATION PACK 2026 KEY
CONCEPTS AND REVISION NOTES
◉ Which route of administration bypasses first-pass metabolism in
the liver
Answer: intravenous
◉ Which method of administration has variable and erratic
absorption
Answer: rectal
◉ What is a half-life?
Answer: the time required for serum plasma concentrations to
decrease by one-half, 50%
◉ When is a steady state reached?
Answer: after 4-5 half lives
◉ What is zero-order (nonlinear) pharmacokinetics
Answer: a drug is metabolized at a constant rate per unit time
,◉ Why is help life important
Answer: -determines how frequently a drug must be administered.
-predicts how long toxic effects can last (when the drug is over the
minimum toxic level)
◉ what is Michaelis-menten pharmacokinetics
Answer: the rate of drug elimination is directly proportional to the
concentration of free drug
◉ Why is peak and trough measured
Answer: to see if a drug is within its therapeutic range
◉ What is narrow therapeutic index
Answer: when the difference between effective dose and a toxic
blood level is small
◉ what is a wide therapeutic index?
Answer: Greater distance between effective dose and toxic dose,
requires less intense monitoring
◉ what is drug potency
Answer: the concentration needed to produce measurable effect
,◉ what is the onset of action
Answer: the point in time when the drug's blood concentration level
elicits a response, the first indication that the drug is having a
therapeutic effect
◉ What is bioequivalence?
Answer: Two drugs that demonstrate comparable bioavailability and
similar times to achieve peak blood concentrations
◉ what is therapeutic equivalent
Answer: Drug products are considered to be therapeutic equivalents
only if they are pharmaceutical equivalents and if they can be
expected to have the same clinical effect and safety profile when
administered to patients.
example: ACE inhibitors (lisinopril, ramipril)
◉ what is therapeutic index
Answer: Ratio of a drug's toxic level to the level that provides
therapeutic benefits
Calculation LD 50 / ED 50
◉ What is margin of safety
, Answer: The margin between the therapeutic and lethal doses of a
drug
◉ Why are loading doses given?
Answer: reach a therapeutic effect quicker
◉ Examples of medications with loading doses
Answer: aminoglycosides (gentamicin) or azithromycin, digoxin
◉ Do loading doses altered for patient metabolism or elimination
Answer: No. Loading doses are the same for every patient
◉ What initiates biochemical reactions
Answer: Drugs bind to cellular receptors. Pharmacological effect is
due to the alteration of an intrinsic physiological process and not the
creation of a new process.
◉ Example of the actions that can occur when a drug binds to a
receptor
Answer: -ion channel is opened or closed
-second messenger is activated (cAMP, cGMP, inositol phosphate,
initiates a series of reactions
-normal cellular function is inhibited
